National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Notice of FY 2020 Arrangement
Notice.
Citation: "84 FR 18063"
Document Number: "Docket ID FEMA-2019-0009"
Page Number: "18063"
"Notices"
Agency: "
SUMMARY: The
DATES: Interested insurers must submit intent to subscribe or re-subscribe to the Arrangement by
FOR FURTHER INFORMATION CONTACT:
SUPPLEMENTARY INFORMATION:
I. Background The National Flood Insurance Act of 1968 (NFIA), as amended (42 U.S.C. 4001 et seq.), authorizes the Administrator of the
Pursuant to this authority,
II. Notice of Availability
Insurers interested in participating in the
Prior participation in the WYO Program does not guarantee that
Any private insurance company with questions may contact
III. Fiscal Year 2020 Arrangement
Pursuant to 44 CFR 62.23(a),
The Fiscal Year 2020 Arrangement reads as follows:
Financial Assistance/Subsidy Arrangement
Article I. Findings, Purposes, and Authority
Whereas, the
Whereas, the
Whereas, the goal of
Whereas, Section 205 of the Bunning-Bereuter-Blumenauer Flood Insurance Reform Act of 2004, Public Law 108-264, as implemented by 44 CFR 62.20, permits Program policyholders to appeal the denial of a claim, completely or in part, to
Whereas, the NFIP is a program administered by
Whereas, the insurer (hereinafter the "Company") under this Arrangement must charge rates established by
Whereas,
Whereas, any litigation resulting from, related to, or arising from the Company's compliance with the written standards, procedures, and guidance issued by
Whereas, through this Arrangement, the United States Treasury will back all flood policy claim payments by the Company; and
Whereas,
Whereas, insured survivors recover faster and more fully than uninsured survivors, and
Whereas, one of the primary objectives of the Program is to provide coverage to the maximum number of buildings at risk and because the insurance industry has marketing access through its existing facilities not directly available to
Whereas, flood insurance policies issued subject to this Arrangement must be only that insurance written by the Company in its own name under prescribed policy conditions and pursuant to this Arrangement, the Act, and any guidance issued by
Whereas, over time, the Program is designed to increase industry participation and, accordingly, reduce or eliminate Government as the principal vehicle for delivering flood insurance to the public; and
Whereas, the sole parties under this Arrangement are the Company and
Now, therefore, the parties hereto mutually undertake the following:
Article II. Undertakings of the Company
A. Eligibility Requirements for Participation in the NFIP.
1.
a. Compliance with the Community Eligibility/Rating Criteria
b. Making Policyholder Eligibility Determinations
c. Policy Issuances
d. Policy Endorsements
e. Policy Cancellations
f. Policy Correspondence
g. Payment of Agents' Commissions
2. Claims Processing. The Company must process all claims consistent with the Standard Flood Insurance Policy, Financial Control Plan, other guidance adopted by
3. Reports. The Company must submit monthly financial reports and statistical transaction reports in accordance with the requirements of the NFIP Transaction Record Reporting and Processing Plan or its successor for the Company and the Financial Control Plan for business written under the WYO Program, as well as with WYO Accounting Procedures.
4. Operations Plan. Within ninety (90) days of the commencement of this Arrangement, the Company must submit an Operations Plan to
a. A marketing plan describing the Company's forecasted growth, efforts to achieve that growth, and ability to comply with any marketing guidelines provided by
b. A description of the Company's NFIP flood insurance distribution network, including anticipated numbers of agents, efforts to train those agents, and an average rate of commissions paid to producers by state.
c. A catastrophic claims handling plan describing how the Company will respond and maintain service standards in catastrophic flood events.
d. A business continuity plan identifying threats and risks facing the Company's NFIP-related operations and how the Company will maintain operations in the event of a disaster affecting its operational capabilities.
B. Time Standards. Time will be measured from the date of receipt through the date mailed out. All dates referenced are working days, not calendar days. In addition to the standards set forth below, all functions performed by the Company must be in accordance with the highest reasonably attainable quality standards generally utilized in the insurance and data processing field. Continual failure to meet these requirements may result in limitations on the company's authority to write new business or the removal of the Company from the WYO Program. Applicable time standards are:
1. Application Processing--15 days (note: if the policy cannot be mailed due to insufficient or erroneous information or insufficient funds, the Company must mail a request for correction or added moneys within 10 days)
2. Renewal processing--7 days
3. Endorsement processing--15 days
4. Cancellation processing--15 days
5. Claims Draft Processing--7 days from completion of file examination
6. Claims Adjustment--45 days average from the receipt of Notice of Loss (or equivalent) through completion of examination
C. Policy Issuance.
1. The flood insurance subject to this Arrangement must be only that insurance written by the Company in its own name pursuant to the Act.
2. The Company must issue policies under the regulations prescribed by the
3. All policies must be issued in consideration of such premiums and upon such terms and conditions and in such states or areas or subdivisions thereof as may be designated by
D.
E. The Company must separate federal flood insurance funds from all other Company accounts, at a bank or banks of its choosing for the collection, retention and disbursement of federal funds relating to its obligation under this Arrangement, less the Company's expenses as set forth in Article III, and the operation of the Letter of Credit established pursuant to Article IV. The Company must remit all funds not required to meet current expenditures to the United States Treasury, in accordance with the provisions of the WYO Accounting Procedures Manual.
F. The Company must investigate, adjust, settle, and defend all claims or losses arising from policies issued under this Arrangement. Payment of flood insurance claims by the Company bind
G. Compliance with Agency Standards and Guidelines.
1. The Company must comply with the Act, regulations, written standards, procedures, and guidance issued by
a. Financial Control Plan
b. Transaction Record Reporting and Processing (TRRP) Plan, or its successor.
c. Flood Insurance Manual
d. Adjuster Claims Manual
e. WYO Bulletins
2. The Company must market flood insurance policies in a manner consistent with marketing guidelines established by
3.
4. The Company must notify its agents of the requirement to comply with State regulations regarding flood insurance agent education, notify agents of flood insurance training opportunities, and assist
H. Compliance with Appeals Process.
1.
a. All records created or maintained pursuant to this Arrangement requested by
b. A comprehensive claim file synopsis that includes a summary of the appeal issues, the Company's position on each issue, and any additional relevant information. If, in the process of writing the synopsis, the Company determines that it can address the issue raised by the policyholder on appeal without further direction, it must notify
2. The Company must cooperate with
3. Resolution of Appeals.
a.
b.
c. The Company independently resolves the issue raised by the policyholder without further direction;
d. The policyholder voluntarily withdraws the appeal; or
e. The policyholder files litigation.
4. Processing of Additional Payments from Appeal. The Company must follow supplemental claim procedures for appeals that result in additional payment to a policyholder.
5. Time Standards.
a. Provide
b. Provide
c. Responding to inquiries from
I. Other
1. Ensure that all public communications (whether written, recorded, electronic, or other) regarding non-NFIP flood insurance lines would not lead a reasonable person to believe that the NFIP,
2. Ensure that data related to this Arrangement are not used to further or support the Company's non-NFIP flood insurance lines.
Article III. Loss Costs, Expenses, Expense Reimbursement, and Premium Refunds
A. The Company is liable for operating, administrative, and production expenses, including any State premium taxes, dividends, agents' commissions or any other expense of whatever nature incurred by the Company in the performance of its obligations under this Arrangement but excluding other taxes or fees, such as municipal or county premium taxes, surcharges on flood insurance premium, and guaranty fund assessments.
1. Operating and Administrative Expenses. The Company may withhold, as operating and administrative expenses, other than agents' or brokers' commissions, an amount from the Company's written premium on the policies covered by this Arrangement in reimbursement of all of the Company's marketing, operating, and administrative expenses, except for allocated and unallocated loss adjustment expenses described in Article III.C. This amount will equal the sum of the average industry expenses ratios for "Other Acq.", "Gen. Exp." and "Taxes" calculated by aggregating premiums and expense amounts for each of five property coverages using direct premium and expense information to derive weighted average expense ratios. For this purpose,
2. Agent Compensation. The Company may retain fifteen (15) percent of the Company's written premium on the policies covered by this Arrangement as the commission allowance to meet the commissions or salaries of insurance agents, brokers, or other entities producing qualified flood insurance applications and other related expenses.
3. Growth Bonus.
4. Reimbursement for Services of a
C.
1.
2.
3.
D. Loss Payments.
1. The Company must make loss payments for flood insurance policies from federal funds retained in the bank account(s) established under Article II.E and, if such funds are depleted, from federal funds derived by drawing against the Letter of Credit established pursuant to Article IV.
2. Loss payments include payments because of litigation that arises under the scope of this Arrangement, and the Authorities set forth herein. All such loss payments and related expenses must meet the documentation requirements of the Financial Control Plan and of this Arrangement, and the Company must comply with the litigation documentation and notification requirements established by
3. Limitation on Litigation Costs.
a. Following receipt of notice of such litigation, the
b. In the event
c. In the event a question arises whether only part of the costs of a litigation is reimbursable, OCC may make a recommendation about the appropriate division of responsibility, if possible.
d. In the event that the Company wishes to petition for reconsideration of the determination that it will not be reimbursed for any part of the award or judgment or any part of the costs expended to defend such litigation made under Article III.D.3.a-c, it may do so by mailing, within thirty (30) days of the notice that reimbursement will not be made, a written petition to
E. The Company must make premium refunds required by
Article IV. Undertakings of the Government
A.
1. Payment of claims, as described in Article III.D;
2. Refunds to applicants and policyholders for insurance premium overpayment, or if the application for insurance is rejected or when cancellation or endorsement of a policy results in a premium refund, as described in Article III.E; and
3. Allocated and unallocated loss adjustment expenses, as described in Article III.C.
B.
1.
2. A mechanism to assist in clarification of coverage and claims questions.
3. Other assistance as needed.
C.
Article V. Commencement and Termination
A. The effective period of this Arrangement begins on
B. Pursuant to 44 CFR 62.23(a),
C. In addition to the requirements of Article V.B, in order to assure uninterrupted service to policyholders, the Company must promptly notify
1.
a. A plan for the orderly transfer to
b. All data received, produced, and maintained through the life of the Company's participation in the Program, including certain data, as determined by
c. All claims and policy files, including those pertaining to receipts and disbursements that have occurred during the life of each policy. In the event of a transfer of the services provided, the Company must provide
d. All funds in its possession with respect to any policies transferred to
e. A point of contact within the Company responsible for addressing issues that may arise from the Company's previous participation under the WYO Program.
2.
a. An assurance of uninterrupted service to policyholders.
b. A detailed transfer plan providing for either: (1) the renewal of the Company's NFIP policies by one or more other WYO companies or (2) the transfer of the Company's NFIP policies to one or more other WYO companies.
c. A description of who the responsible party will be for liabilities relating to losses incurred by the Company in this or preceding Arrangement years.
d. A point of contact within the Company responsible for addressing issues that may arise from the Company's previous participation under the WYO Program.
D. Cancellation by
1.
a. Fraud or misrepresentation by the Company subsequent to the inception of the Arrangement; or
b. Nonpayment to
c. Material failure to comply with the requirements of this Arrangement or with the written standards, procedures, or guidance issued by
2. If
3. As an alternative to the transfer of the policies to
E. In the event that the Company is unable or otherwise fails to carry out its obligations under this Arrangement by reason of any order or directive duly issued by the
F. In the event the Act is amended, repealed, expires, or if
Article VI. Information and Annual Statements
A. The Company must furnish to
B. Upon
Article VII. Cash Management and Accounting
A.
B. The Company must remit all funds, including interest, not required to meet current expenditures to the United States Treasury, in accordance with the provisions of the WYO Accounting Procedures Manual or procedures approved in writing by
C. In the event the Company elects not to participate in the Program in this or any subsequent fiscal year, or is otherwise unable or not permitted to participate, the Company and
Article VIII. Arbitration
If any misunderstanding or dispute arises between the Company and
The two arbitrators so chosen, if they are unable to reach an agreement, must select a third arbitrator who must act as umpire, and such umpire's determination will become final only upon approval by
This Article shall indefinitely succeed the term of this Arrangement.
Article IX. Errors and Omissions
In the event of negligence by the Company that has not resulted in litigation but has resulted in a claim against the Company,
Further, if the claim against the Company is grounded in actions significantly outside the scope of this Arrangement or if there is negligence by the agent,
However, in the event that the Company has made a claim payment to an insured without including a mortgagee (or trustee) of which the Company had actual notice prior to making payment, and subsequently determines that the mortgagee (or trustee) is also entitled to any part of said claim payment, any additional payment may not be paid by the Company from any portion of the premium and any funds derived from any federal letter of credit deposited in the bank account described in Article II.E. In addition, the Company agrees to hold the Federal Government harmless against any claim asserted against the Federal Government by any such mortgagee (or trustee), as described in the preceding sentence, by reason of any claim payment made to any insured under the circumstances described above.
Article X. Officials Not To Benefit
No Member or Delegate to
Article XI. Offset
At the settlement of accounts, the Company and
All debts or credits of the same class, whether liquidated or unliquidated, in favor of or against either party to this Arrangement on the date of entry, or any order of conservation, receivership, or liquidation, shall be deemed to be mutual debts and credits and shall be offset with the balance only to be allowed or paid. No offset shall be allowed where a conservator, receiver, or liquidator has been appointed and where an obligation was purchased by or transferred to a party hereunder to be used as an offset.
Although a claim on the part of either party against the other may be unliquidated or undetermined in amount on the date of the entry of the order, such claim will be regarded as being in existence as of the date of such order and any credits or claims of the same class then in existence and held by the other party may be offset against it.
Article XII. Equal Opportunity
The Company shall not discriminate against any applicant for insurance because of race, color, religion, sex, age, handicap, marital status, or national origin.
Article XIII. [Reserved]
[Reserved]
Article XIV. Access to Books and Records
Article XV. Compliance With Act and Regulations
This Arrangement and all policies of insurance issued pursuant thereto are subject to federal law and regulations.
Article XVI. Relationship Between the Parties and the Insured
Inasmuch as the Federal Government is a guarantor hereunder, the primary relationship between the Company and the Federal Government is one of a fiduciary nature, that is, to assure that any taxpayer funds are accounted for and appropriately expended. The Company is a fiscal agent of the Federal Government, but is not a general agent of the Federal Government. The Company is solely responsible for its obligations to its insured under any policy issued pursuant hereto, such that the Federal Government is not a proper party to any lawsuit arising out of such policies.
Authority: 42 U.S.C. 4071, 4081; 44 CFR 62.23.
Deputy Associate Administrator for Insurance and Mitigation,
[FR Doc. 2019-08605 Filed 4-26-19;
BILLING CODE 9111-52-P


Research center brushes off ashes after January blaze
Republicans call Dems socialists. Will 2020 voters buy it?
Advisor News
- What advisors must know about accessible client documents
- Your client texted. Now what? The compliance rules advisors better know
- Helping small-business owners build, grow and exit
- Help women break through their retirement roadblocks
- Advisors await SEC decision on Vanguard fair fund distribution
More Advisor NewsAnnuity News
- Wink: Annuity sales post strong Q2, led by MYGAs and structured products
- Legacy Marketing Group partners with Malibu Life USA for annuity launch
- Best’s Market Segment Report: Global Life/Annuity Reinsurers Remained Poised for Steady Growth
- When technology becomes easy to rent, what still separates life and annuity carriers?
- Legacy Marketing Group® and Malibu Life USA Announce Distribution Partnership for New Fixed Indexed Annuity Platform
More Annuity NewsHealth/Employee Benefits News
Life Insurance News